Lack of long-term follow-up after paediatric-adult transition in coeliac disease is not associated with complications, ongoing symptoms or dietary adherence.

BACKGROUND

Follow-up of coeliac disease is recommended to prevent complications associated with unsuccessful treatment.

OBJECTIVE

The objective of this article is to evaluate the implementation and significance of long-term follow-up.

METHODS

Medical data were collected from 585 and follow-up questionnaires sent to 559 current adult coeliac disease patients diagnosed in childhood. Diagnostic features and adulthood health outcomes were compared between those with and without adulthood follow-up.

RESULTS

Of paediatric patients, 92% were followed up 6-24 months after diagnosis. A total of 235 adults responded to the questionnaires a median of 18 years after diagnosis, and 25% of them reported regular follow-up. They were diagnosed more recently than those without follow-up (median year 2001 vs 1995,  = 0.001), being otherwise comparable at diagnosis. Those with follow-up were less often smokers (5% vs 16%,  = 0.042) and relatives of coeliac patients (48% vs 66%,  = 0.018), and more often students (48% vs 28%,  = 0.005) and type 1 diabetics (19% vs 4%,  = 0.001). Lack of follow-up was not associated with complications, ongoing symptoms, poorer general health or dietary adherence. All completely non-adherent patients were without follow-up.

CONCLUSIONS

Most coeliac disease patients diagnosed in childhood were not followed up according to recommendations in adulthood. The individual effect of this on long-term treatment outcomes varied markedly.